Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | NJ | |
N | 2084N0400X | Neurologist | NJ |
NPI | 1154539492 |
---|---|
Provider Name | Dr. Thomas Robert Zimmerman JR. |
First Address | Bernardsville, NJ 07924-1626 |
Second Address | Bernardsville, NJ 07924-2313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1221906 | (05) | NJ |
53F98 | NJ-BLUE SHIELD (01) | NJ |
58114386B | WELFARE (01) | NJ |
E52646 | (02) | NJ |